Thing Health Insurance Should NOT Cover

Lately all we hear is healthcare reform. We demand health insurance cover more but we want to pay less. Some of us have even gone as far as demanding government run universal healthcare. Before we take such drastic measures I suggest a few simple alterations in insurance plans: Stop covering unnecessary things!!! What I mean by unnecessary things, I mean things like ED drugs such as Viagra, Cialis, and Levitra. It appalls me that certain Medicare plans cover it. It made my stomach turn when once I read an article about people fighting their health insurance companies to pay for in vitro fertilization. They even got as far as getting elected officials to try and pass a bill for it. I know life without sex or kids sucks but it’s not life threatening and it’s not going to kill you unlike cancer or heart disease. Not all insurance companies cover these things but it appalls me that some even do.

People need to realize that health insurance companies are businesses. Yes they’re goal is profit, yes they have A LOT of money, but they don’t have all the money in the world. Just like any other business out there, they have to at the very least stay afloat. Anyone who has worked in businesses, especially retail or sales knows that sometimes corners have to be cut to keep profits up. If a particular item or service is not selling or not making the wanted profits of the money invested in it, then sale of the item of service needs to stop.

The Cost Of Coverage

For people who are wondering where I get the prices of all these medications, I’m an assistant manager in a retail drug store; I have to look up these prices all the time.

The average price for an ED pill is about $25. Although that doesn’t sound like much put it on a grand scale. Let’s say a person needs 100 of these pills a year, that costs the insurance company $2500 per person. Put it towards the whole population, that’s $2.5 million for every thousand people that take it. Wouldn’t you rather have that $2.5 million dollars be used on paying for someone’s cancer treatment, or heart surgery? A colleague of mine, her husband had a lung transplant a few years ago. In order to stay alive he needs anti-rejection drugs. Every month those drugs cost him $2500. If the insurance companies needed the money, all they have to do is reject 12 annual prescriptions for ED drugs to pay for his anti-rejection drugs. Those 12 people can live without ED drugs; this man can’t live without his anti-rejection drugs.

It’s the same story with in vitro fertilization. If you want numbers, artificial insemination costs at least $3000 each time regardless if it is successful or not. The whole in vitro cycle costs about $12,500, successful or not.

What About Other Unncessary Things?

Well, a lot of people would argue with me the fact that health insurance already pays for thing that seem unnecessary, things like breast reconstruction after a mastectomy or diet plans or stop smoking aids. Well unlike paying for ED drugs or in vitro fertilization, paying for these other things is an investment so the health insurance companies can avoid higher medical bills for other ailments in the future. Quite a few women who have a family history of breast cancer are talked into getting mastectomies to be gone with the problem to begin with. Most women are turned off by the idea so insurance companies are willing to pay for reconstruction, which is about $10,000, on top of the mastectomy in hopes that the woman will not get breast cancer in return avoiding hundreds of thousands of dollars of medical bills in the future for cancer treatment. A $10,000+ investment right now to avoid $100,000+ problems in the future. Same principle covering diet plans and smoking aids. We all know the health problems that come with obesity and smoking. Pay for the weight loss and stop smoking plans now to avoid higher priced problems in the future.

Afterthought

The article about people fighting their insurance companies to pay for in vitro fertilization had a message board attached and several of these arguments got me thinking. Someone pointed out that insurance covering ED drugs and in vitro fertilization will make someone happier and more confident. Happiness and confidence will make someone take better care of him/herself and in return have fewer health problems. Although that could be true, it could start a whole slew of claims. A lot of us feel that liposuction, breast implants, face-lifts, and virtually any other type of plastic surgery will make us feel better. Where will the line be drawn? Another argument was that, taking from the point I mentioned in the previous paragraph, instead of reducing future costs, it would increase future costs.

This only mentions two things that appall me that certain health insurances cover. If anything else comes up that appalls me I will definitely have a follow up article